Your tummy goes through a tremendous amount when you are pregnant, stretching multiple times its size to fit your precious bundle. So once your baby is here your tummy can look a little different to before (mine felt like a deflated balloon!). The line in the middle might appear wider, your tummy may bulge outwards when doing activity, and you might find that you simply can't do the exercise that you used to. Whilst this is completely normal and part of the usual post natal recovery, for some women this can go on for a longer time with some living with the changes for the rest of their lives. However with physiotherapy we CAN make it better, regardless of how long its been there!
So what is it?
The technical term for this is a diastasis recti. If you imagine your 'six pack' abs, it's where the line vertically down the middle becomes wider. The muscles have been moved apart, which means that they are working less efficiently in the centre of the stomach where the widening has occurred. For some women this causes a bulging in the centre of the stomach. This is caused by the inability to keep the tummy tight during exercise so our body splints it instead to create the tension that was there before. A bit like blowing up a balloon to create tension in the rubber. This occurs 100% of the time during pregnancy and is perfectly normal. 60% of women have this post natally and can then take up to 8-12 weeks for this increased size to reduce down.
What effect does it have?
Some women experience a bulging look down the centre of their stomach, some women struggle with getting back to activity and some find aches and pains occur both on the stomach itself and in other areas of their body as the body compensates for this weakness. These areas could be back pain, hip pain or pelvic pain. If there are already incontinence issues, this diastasis recti could make it worse, however there is NO link to one causing the other.
What can I do about it?
See a specialist physiotherapy that is used to treating pregnancy and post natal issues to give you an in depth assessment and provide you with recommendations specific to your needs.
Don't over do the exercise! Exercise is an amazing thing during and after pregnancy. However it's the type of exercise that we do that makes the difference. We recommend avoiding any core workouts until at least 6-8 weeks and not starting any running until 12 weeks. Although you may be a keen bean to get back to exercise or lose the baby weight, your body will thank you for taking it steady in the first 3 months
Pick gentle control based exercise such as yoga or pilates. You shouldn't start this until 6 weeks post natal but it is a fantastic way of getting yourself back into exercise again before starting anything more strenuous.
Pelvic floor exercise. I can't stress how helpful pelvic floor exercise is for the post natal body! However there is more to it than a 'squeeze' every once in a while. It's great exercise to start early on and lays the foundation to more difficult activity such as running. A video will be coming soon looking at the top 3 pelvic floor exercises to try! I would also recommend seeing a physiotherapist to go through an exercise programme specifically for you.
Support the tummy. In the early days some women find support around the stomach helpful such as tubey grip or compression bandage. This provides gentle tension to the stomach.
So will it ever go?
This answer to this is more complicated than a yes or no. With the right guidance and physiotherapy it will definitely get better. Your stomach will stop bulging and the gap will reduce. For some women the gap can reduce completely, for others there will always remain a gap. The gap would be purely cosmetic as the stomach itself is working as it was pre-pregnancy.
What about surgery?
Surgery is something that pops up if you google 'Diastasis Recti'. I want to rest your mind at ease to say that surgery is not a common treatment option for this issue and is actually very rare. The majority of the time is done for cosmetic reasons rather than functional reasons. In order to have the surgery, extensive rehab needs to be completed first. After surgery it is not recommended to get pregnant again as it will restrict any stretch around the stomach, which is obviously needed during pregnancy, so this is something to consider if you are looking into surgery. A consultant will be able to give you more information about surgery if that is a route you would like to go down.
If you'd like to know more about diastasis recti Munira Hudani's social media pages and website have some great resources! https://www.munirahudanipt.com/
If you are worried you may have a diastasis recti please get in touch for an appointment.